Surgical instrument with curvilinear tissue-contacting surfaces

ABSTRACT

A surgical stapling instrument including a handle assembly, an elongated body portion, a shell assembly and an anvil assembly. The elongated body portion extends distally from the handle assembly and defines a longitudinal axis. The shell assembly is disposed adjacent a distal end of the elongated body portion and includes a non-planar, tissue-contacting surface oriented obliquely with respect to the longitudinal axis. The anvil assembly includes a non-planar, tissue-contacting surface oriented obliquely with respect to the longitudinal axis. The tissue-contacting surface of the anvil assembly is configured to align with the tissue-contacting surface of the shell assembly when the anvil assembly and shell assembly are in the approximated position.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application is a Continuation Application of U.S.application Ser. No. 12/793,326, filed Jun. 3, 2010, which claimspriority to U.S. Provisional Application Ser. No. 61,227,134, filed Jul.21, 2009, the entire contents of which are incorporated herein byreference.

This application claims priority to provisional application Ser. No.61/227,134, filed Jul. 21, 2009, the entire contents of which areincorporated herein by reference.

BACKGROUND

1. Technical Field

The present disclosure relates generally to a surgical staplinginstrument for applying surgical staples to body tissue.

2. Background of Related Art

Anastomosis is the surgical joining of separate hollow tissue sections.Typically, an anastomosis procedure follows surgery in which a diseasedor defective section of hollow tissue is removed and the remaining endsections are to be joined. Depending on the desired anastomosisprocedure, the end sections may be joined by either circular, end-to-endor side-to-side organ reconstruction methods.

In a circular anastomosis procedure, the two ends of the tissue sectionsare joined by means of a stapling instrument which drives a circulararray of staples through the end section of each tissue section andsimultaneously cores any tissue interior of the driven circular array ofstaples to free the tubular passage. Examples of instruments forperforming circular anastomosis of hollow organs are described in U.S.Pat. Nos. 6,053,390, 5,588,579, 5,119,983, 5,005,749, 4,646,745,4,576,167, and 4,473,077, each of which is incorporated herein in itsentirety by reference. Typically, these instruments include an elongatedshaft having a handle portion at a proximal end to actuate theinstrument and a staple holding component disposed at a distal end. Ananvil assembly including an anvil rod with attached anvil head ismounted to the distal end of the instrument adjacent the staple holdingcomponent. Opposed end portions of tissue of the hollow tissuesection(s) to be stapled are clamped between the anvil head and thestaple holding component when these components are approximated. Theclamped tissue is stapled by driving one or more staples from the stapleholding component so that the ends of the staples pass through thetissue and are deformed by pockets or depressions in the anvil head. Anannular knife is concurrently advanced to core tissue within the hollowtissue sections to free a tubular passage within the organ.

Besides anastomosis of hollow organs and tissue, surgical staplinginstruments for performing circular anastomosis have been used to treatinternal hemorrhoids in the rectum. Typically, during use of a circularstapling instrument for hemorrhoid treatment, the anvil head and thestaple holding component of the surgical stapling instrument areinserted through the anus and into the rectum with the anvil head andthe staple holding component in an open or unapproximated position.Thereafter, a pursestring suture is used to pull the internalhemorrhoidal tissue towards the anvil rod. Next, the anvil head and thestaple holding component are approximated to clamp the hemorrhoid tissuebetween the anvil head and the staple holding component. The staplinginstrument is fired to remove the hemorrhoidal tissue or tissue adjacentthe hemorrhoidal tissue and staple the cut tissue.

SUMMARY

The present disclosure relates in one aspect to a surgical staplinginstrument including a handle assembly, an elongated body portion, ashell assembly and an anvil assembly. The elongated body portion extendsdistally from the handle assembly and defines a longitudinal axis. Theshell assembly is disposed adjacent a distal end of the elongated bodyportion and includes a non-planar, tissue-contacting surface orientedobliquely with respect to the longitudinal axis. The anvil assemblyincludes a non-planar, tissue-contacting surface oriented obliquely withrespect to the longitudinal axis and aligned with the tissue contactingsurface of the shell assembly in the approximated position.

In one embodiment, the tissue-contacting surface of the shell assemblyand the tissue-contacting surface of the anvil assembly are eachcurvilinear along at least a portion of their lengths. In oneembodiment, the curvilinear segments are separated by a concave pointand a convex point. In one embodiment, the tissue-contacting surface ofthe anvil assembly and shell assembly includes at least one convexlycurved section and at least one concavely curved section The shellassembly and the anvil assembly preferably create a staple line disposedobliquely with respect to the longitudinal axis. The shell assembly andthe anvil assembly can create a substantially elliptical staple line.

In one embodiment, the anvil assembly includes an anvil rod detachablymountable to the surgical instrument.

In one embodiment, the tissue-contacting surface of the anvil assemblyincludes two curvilinear segments, each curvilinear segment being asubstantially mirror image of the other.

DESCRIPTION OF THE DRAWINGS

Various embodiments of the presently disclosed surgical staplinginstrument are disclosed herein with reference to the drawings, wherein:

FIG. 1 is a perspective view of the presently disclosed surgicalstapling instrument illustrated in an unapproximated position, inaccordance with an embodiment of the present disclosure;

FIG. 2 is a side view of the surgical stapling instrument of FIG. 1illustrated in an approximated position;

FIG. 3 is a longitudinal, cross-sectional view of a handle portion ofthe surgical stapling instrument of FIG. 1 in the unapproximatedposition;

FIG. 4 is a longitudinal, cross-sectional view of the handle portion ofthe surgical stapling instrument of FIG. 1 in the approximated unfiredposition, of FIG. 2;

FIG. 5 is a longitudinal, cross-sectional view of the handle portion ofthe surgical stapling instrument of FIG. 1 in the fired position;

FIGS. 6 and 7 are perspective and side views, respectively, of thedistal end of the surgical stapling instrument of FIG. 1 illustrated inthe unapproximated position;

FIG. 8 is a perspective view of the distal end of the surgical staplinginstrument of FIG. 1 illustrated in the approximated position clampingtissue;

FIG. 9 is a plan view of a staple line resulting from the firing of thesurgical stapling instrument of FIG. 1; and

FIGS. 10 and 11 are perspective views of the distal end of the surgicalinstrument of FIG. 1 in the unapproximated position.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed surgical stapling instrument willnow be described in detail with reference to the drawings in which likereference numerals designate identical or corresponding elements in eachof the several views.

Throughout this description, the term “proximal” will refer to theportion of the instrument closer to the operator and the term “distal”will refer to the portion of the instrument farther from the operator.

FIGS. 1-2 illustrate one embodiment of the presently disclosed surgicalstapling instrument shown generally as 10. Briefly, surgical staplinginstrument 10 includes a handle assembly 12, an elongated body portion14 including a curved elongated outer tube 14 a, and a head portion 16.Alternately, in some surgical procedures, e.g., the treatment ofhemorrhoids, it is desirable to have a substantially straight bodyportion. The length, shape and/or the diameter of body portion 14 andhead portion 16 may also be varied to suit patient size and/or aparticular surgical procedure.

With continued reference to FIGS. 1-2, handle assembly 12 includes astationary handle 18, a firing trigger 20, a rotatable approximationknob 22 and an indicator mechanism 100. Head portion 16 includes ananvil assembly 200 and a shell assembly 220. Anvil assembly 200 ismovable in relation to shell assembly 220 between spaced andapproximated positions.

With continued reference to FIGS. 1-2, in operation, rotation ofapproximation knob 22 causes movement of anvil assembly 200 in relationto shell assembly 220 between spaced (unapproximated) (FIG. 1) andapproximated (FIG. 2) positions, as approximation knob 22 ismechanically engaged with an anvil retainer 38 (FIG. 1), which isfastened to anvil assembly 200. An anvil shaft of anvil assembly 200 ispreferably removably mounted within anvil retainer 38 to removablyconnect the anvil assembly 200 to the stapling instrument. It isenvisioned that rotation of approximation knob 22 in a first direction(e.g., clockwise) causes proximal movement of anvil assembly 200, androtation of approximation knob 22 in a second opposite direction (e.g.,counter-clockwise) causes distal movement of anvil assembly 200.

Referring now to FIGS. 3-5, approximation knob 22 is mechanicallyengaged with a spiral cam or screw stop 40, and screw stop 40 is inmechanical cooperation with anvil assembly 200. Rotation ofapproximation knob 22 in the first direction causes screw stop 40 tomove proximally, which in turn causes proximal movement of anvilassembly 200, such approximation described in detail in U.S. Pat. No.7,303,106, the entire contents of which are incorporated herein byreference.

Additionally, the embodiments illustrated in FIGS. 3-5 show a lockoutmechanism including a trigger lock 50. Trigger lock 50 is disposed inmechanical cooperation with handle assembly 12 and maintains firingtrigger 20 in an open position until anvil assembly 200 and shellassembly 220 have been approximated. As can be appreciated, the lockoutmechanism helps prevent staples from being fired prematurely. Moreparticularly, it is envisioned that as screw stop 40 moves proximally, aportion of screw stop 40 urges a portion of the lockout mechanismproximally against the bias of spring 42, thus allowing the pivoting oftrigger lock 50 in the substantial direction of arrow “B” in FIG. 4 topermit firing of surgical stapling instrument 10.

With regard to indicator mechanism 100, it is envisioned that anindicator 102 is movable between a first position, which providesindication that the instrument 10 has not been approximated and is notin a fire-ready condition, a second position, which provides indicationthat the instrument has been approximated and is now in a fire-readyposition, and third position, which provides indication that theinstrument has been fired.

It is envisioned that during approximation of anvil assembly 200 withrespect to shell assembly 220, a tab 41 of screw stop 40 passes througha slot of a slide member 110 and engages a proximal end of the slot.Continued approximation causes indicator 102 to pivot to its secondposition. The lockout mechanism and indicator mechanisms are disclosedin U.S. Pat. No. 7,303,106, the entire contents of which have previouslybeen incorporated herein by reference.

A complete actuation of firing trigger 20 causes indicator 102 to pivotfrom its second position to its third position. Specifically, oncefiring trigger 20 is completely actuated, a tab 23 disposed on firingtrigger 20 contacts a pawl 60 of stationary handle 18. The engagementbetween tab 23 and pawl 60 causes pawl 60 to rotate in the generaldirection of arrow “C” in FIG. 5. As pawl 60 rotates, a rib of pawl 60contacts an extension 116 of slide member 110, causing proximaltranslation of slide member 110. As slide member 110 translatesproximally, its mechanical engagement with indicator 102 causesindicator 102 to move to a third position. In the third position,indicator 102 provides indication to a surgeon that the instrument hasbeen fired.

Actuation of firing trigger 20 (i.e., pivoting in the direction of arrow“A” in FIG. 3), causes staples to be ejected from shell assembly 220distally towards anvil assembly 200. That is, firing trigger 20 isdisposed in mechanical cooperation with a pusher (not explicitly shownin the illustrated embodiments), such that actuation of firing trigger20 causes advancement of the pusher into contact with the staples toeject the staples into staple deforming pockets of anvil assembly 200.Such actuation is disclosed in U.S. Pat. No. 7,303,106, incorporated byreference above.

Referring now to FIGS. 6-8 and 10-11, the head portion 16 of surgicalstapling instrument 10 is shown in various stages of operation. Moreparticularly, FIGS. 6, 7, 10 and 11 illustrate anvil assembly 200 andshell assembly 220 in the spaced, or unapproximated position and FIG. 8illustrates anvil assembly 200 and shell assembly 220 in theapproximated position. As illustrated, shell assembly 220 includes anon-planar (e.g., curvilinear), tissue-contacting surface 222 that isoriented obliquely with respect to a longitudinal axis “A-A” (FIG. 1)defined by elongated body portion 14. Additionally, anvil assembly 200includes a non-planar (e.g., curvilinear), tissue-contacting surface 202oriented obliquely with respect to the longitudinal axis “A-A.” As shown(in FIG. 8, for example), the configuration of tissue-contacting surface202 of anvil assembly 200 aligns with the configuration of thetissue-contacting surface 222 of shell assembly 220. That is, in theabsence of tissue between the tissue contacting surfaces 202, 222, whenanvil assembly 200 in its approximated position, it would matinglyengage shell assembly 222. In use though, tissue is clamped betweenthese two assemblies 200, 220.

With reference to FIGS. 6, 7, 10 and 11, tissue-contacting surface 202of anvil assembly 200 comprises a complex curve with concave and convexsurfaces. More specifically, surface 202 has an elongated shape suchthat the straight line distance from points 207 a, 207 b is greater thanthe straight line distance from points 209 a, 209 b. The surface 202includes a curve having a convex portion 204, with convex end 207 b, aconcave portion 203 a, 203 b emanating from convex portion 204 on eachside, then transitioning into another convex portion 208 a, 208 bextending to concave portion 205 with concave end 207 a.

Tissue contacting surface 222 of shell assembly 220 comprises a complexcurve with concave and convex surfaces. It has as elongated shape suchthat the straight line distance from points 227 a, 227 b is greater thanthe straight line distance from points 229 a, 229 b. The surfaceincludes a curve having a concave portion 224 with a concave end 227 b,a convex portion 226 a, 226 b emanating from the concave portion 224,then transitioning into another concave portion 228 a, 228 b extendingto convex portion 225 with convex end 227 a. The opening in the shellassembly is designated by reference numeral 229.

Thus, with particular reference to FIG. 11, viewed another way,tissue-contacting surface 202 of anvil assembly 200 includes twocurvilinear segments which are separated by a concave end 207 a andconvex end 207 b. Similarly, and with reference to FIG. 10, shellassembly 220 (e.g., tissue-contacting surface 222 thereof) includes twocurvilinear segments, which are separated by a concave end 227 b and aconvex end 227 a. As can be appreciated with reference to the Figures,concavity and convexity are with respect to the respectivetissue-contacting surfaces of anvil assembly 200 and shell assembly 220.As can be appreciated, these multiple curves provide a helical “sweep”configuration or an S-like curve. Convex portion 204 of anvil assembly200 is configured to align with concave portion 224 of shell assembly220, and concave portion 205 of anvil assembly 200 is configured toalign with convex portion 225 of shell assembly 220 when approximated.Such configuration provides the tissue-contacting surfaces with aribbon-like shape. Consequently, the anvil assembly has first and secondarrays of pockets to receive fasteners fired from the shell assembly,the first array lying in multiple non-parallel planes and the secondarray lying in multiple non-parallel planes. The shell assembly has afirst and second array of fasteners wherein each array lies in multiplenon-parallel planes.

Referring now to FIG. 9, a staple line 300 is shown. The staple linethat results from mating cooperation between anvil assembly 200 andshell assembly 220 is substantially elliptical (as shown) and isdisposed obliquely (i.e., not perpendicular) with respect tolongitudinal axis “A-A.” As can be appreciated, staple line 300 having asubstantially elliptical shape includes a greater cross-sectional areathan a circular cross-section resulting from when the tissue-contactingsurfaces of a shell and anvil are disposed perpendicularly with respectto a longitudinal axis. That is, the cross-sectional configuration ofthe staple line, i.e. substantially elliptical, created by utilizationof the disclosed instrument 10 (and more specifically, head portion 16)increases the length of the staple line and due to its shape, whenstricture occurs, it has a minimal affect on the reduction of theoverall diameter of the staple line, thereby facilitating a patient'sability to pass waste.

Further details of other features of surgical instrument 10, such as theapproximation assembly, firing assembly, lock out mechanism andindicator mechanism are disclosed in commonly-owned U.S. Pat. Nos.7,168,604 and 7,303,106, the entire contents of each of which areincorporated by reference herein.

It will be understood that various modifications may be made to theembodiments disclosed herein. Therefore, the above description shouldnot be construed as limiting, but merely as exemplifications ofdisclosed embodiments.

What is claimed is:
 1. A surgical instrument, comprising: a handleassembly; an elongated body portion extending distally from the handleassembly and defining a longitudinal axis; a first jaw member disposedadjacent a distal end of the elongated body portion, the first jawmember including a non-planar tissue-contacting surface; and a secondjaw member having a non-planar tissue-contacting surface, and theentirety of, the non-planar tissue-contacting surface of the second jawmember divided into exactly two curvilinear segments, each curvilinearsegment including exactly one concave portion and exactly one convexportion, wherein the tissue-contacting surface of the second jaw memberis configured to align with the tissue-contacting surface of the firstjaw member when the second jaw member and the first jaw member are in anapproximated position.
 2. The surgical instrument of claim 1, whereinthe non-planar tissue-contacting surface of the first jaw member isdivided into exactly two curvilinear segments, and wherein thecurvilinear segments of the tissue-contacting surface of the first jawmember are separated by a concave point and a convex point.
 3. Thesurgical instrument of claim 2, wherein the curvilinear segments of thetissue-contacting surface of the second jaw member are separated by aconcave point and a convex point.
 4. The surgical instrument of claim 1,wherein elongated body portion includes a longitudinally curved portion.5. The surgical instrument of claim 1, wherein the tissue-contactingsurface of the first jaw member is curvilinear along at least a majorityof its length.
 6. The surgical instrument of claim 5, wherein thetissue-contacting surface of the second jaw member is curvilinear alongat least a majority of its length.
 7. The surgical instrument of claim1, wherein the second jaw member includes first and second arrays ofpockets to receive fasteners fired from the first jaw member, the firstarray lying in multiple non-parallel planes.
 8. The surgical instrumentof claim 1, wherein the first jaw member includes first and secondarrays of fasteners at least partially therein, each array lying inmultiple non-parallel planes.
 9. The surgical instrument of claim 1,wherein the second jaw member includes a rod detachably mountable to thesurgical instrument.
 10. The surgical instrument of claim 1, wherein thetwo curvilinear segments of the tissue-contacting surface of the secondjaw member are substantially mirror images of each other.
 11. Thesurgical instrument of claim 10, wherein the non-planartissue-contacting surface of the first jaw member is divided intoexactly two curvilinear segments, and wherein the two curvilinearsegments of the tissue-contacting surface of the first jaw member aresubstantially mirror images of each other.
 12. The surgical instrumentof claim 1, wherein the tissue-contacting surface of the first jawmember is oriented obliquely with respect to the longitudinal axis. 13.The surgical instrument of claim 12, wherein the tissue-contactingsurface of the second jaw member is oriented obliquely with respect tothe longitudinal axis.